Effect of continuous high volume hemofiltration on blood kinetics and oxygen metabolism in acute respiratory distress syndrome

Objective To investigate the effect of continuous high volume hemofiltration on blood kinetics and oxygen metabolism in acute respiratory distress syndrome (ARDS). Methods Twelve adult patients with ARDS who received mechanical ventilation were treated with CHVHF (6L/h) for 72 hours. The cardiac output(CO),systemic vascular resistance(SVR),pulmonary vascu- lar resistance(PVR),mean pulmonary arterial pressure(mPAP)、pulmonary artery wedge pressure (PAWP)、arterial oxygen content(CaO2)、content of mixed venous blood(CvO2)、oxygen consumption(VO2)and oxygen extraction rate (O2ER)were measured by Swan-Ganz catheter, the thoracic fluid content were measured with BioZ? Cardio Dynamics. Concentrations of TNFα, IL-6,IL-8 and IL-10 were measured pre-CHVHF and after CHVHF by ELISA. Results There were significant descent of TNFα,IL-1,IL-6 and IL-8 levels after CHVHF at 72 hours(P0.05),and PAP and PVR after 24 hours(P 0.05). The stabilization of DO2、VO2 and O2ER was at 72 hours with amelioration of PaO2/FiO2 and peak airway pressure (Ppeak) (P0.05).Conclusion CHVHF shows significant beneficial effects on pulmonary function of ARDS as the result of removal of cytokines and ameliorationtion of oxygen metabolism .